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Behavioral-health facility construction is expanding as more people seek mental-health and substance-use care, but the evidence in this article supports a historical design and planning trend—not a current market-size forecast. A 2021 Building Design + Construction report linked wider acceptance of treatment with opportunities for architecture, engineering and construction (AEC) firms. It also documented projects that replace institutional environments with safer, more welcoming and more flexible settings. For builders, the practical lesson is to start with the care model and patient population, then coordinate safety, privacy, family access, staff wellbeing, nature, operations and delivery method around that model.
What does the reported rise in behavioral-health construction actually mean?
The phrase “demand is rising” comes from the January 9, 2021 Building Design + Construction article, which described greater acceptance of mental-health treatment and a need for additional facilities. It should not be read as a current, quantified market forecast. The article combined pandemic-era need indicators, project announcements and professional observations; those figures describe the period reported, not 2026 prevalence or construction volume.
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Two statistics explain the context. In a KFF Tracking survey of 1,313 U.S. adults conducted in July 2020, 53% said the coronavirus pandemic had negatively affected their mental health, as reported by BD+C. The same article attributed an estimate to the National Institute of Mental Health that 26% of Americans suffer from a diagnosable mental disorder in a given year. Neither figure is a present-day estimate of facility demand, and neither establishes that destigmatization alone caused new construction.
Jonathan Ward, FAIA, a design partner in NBBJ’s Los Angeles office, told BD+C: “Before the pandemic, most of these places weren’t very nice. Now, society is destigmatizing mental health, and here is an opportunity for people to get treatment in better settings.” That observation is useful for project teams because it frames quality, dignity and usability as capital-planning issues, not decorative upgrades.
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Which types of behavioral-health facilities need to be planned?
There is no single “treatment center” prototype. A facility may provide emergency evaluation, short observation, inpatient treatment, residential care, partial hospitalization, intensive outpatient programming or routine outpatient services. Each level has different staffing, security, observation, bedroom, group-room, medication, family and building-services requirements.
- Crisis and psychiatric emergency care: Design for rapid arrival, de-escalation, controlled circulation, medical assessment and safe handoffs. Observation rooms, secure storage and direct staff sightlines can be more important than hotel-like finishes.
- Short observation and stabilization: Patients may stay for up to 24 or 72 hours. Rooms, toilets, nurse bases and family consultation areas must support close monitoring without making every space feel punitive.
- Inpatient units: Longer stays require bedrooms, treatment and activity spaces, medication support, staff work areas, visitor management and ligature-aware detailing. The care plan should determine the balance between visibility and privacy.
- Residential programs: A residential setting supports daily living, therapy and recovery over a longer period. Domestic scale, kitchens, gardens and community rooms may be appropriate, while controlled access and observation remain essential.
- Partial hospitalization and intensive outpatient programs: These programs need flexible group rooms, quiet rooms, classrooms or life-skills areas, intake space and efficient arrival/departure patterns. They often serve people who return home the same day.
- Outpatient and community services: Privacy at reception, acoustical separation, accessible consultation rooms and discreet arrival options can reduce barriers to attendance.
Programs can coexist on one campus, but shared space should not create unsafe cross-traffic or expose a patient’s status. AEC teams should map acuity, duration of stay, age group, diagnoses served, family role and staffing model before drawing a generic floor plan.
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Begin with an operational brief, not a finish schedule. Confirm who arrives, who can leave independently, what must be observed continuously, which activities are therapeutic, and where staff need private work or recovery space. Then test the brief against normal operations, a behavioral emergency, a visitor surge, a medical emergency and a maintenance event.
- Define the population and acuity. Document age ranges, mobility, sensory needs, language access, co-occurring medical conditions and the highest-risk behaviors the facility must safely manage.
- Map journeys. Draw separate or carefully controlled routes for patients, families, staff, food, medications, waste, deliveries and emergency responders. Identify where privacy is required and where staff need visual control.
- Set observation and privacy rules. Decide which rooms require direct sightlines, which can use intermittent observation, and where patients can have confidential conversations. Visibility should not mean constant exposure.
- Coordinate safety details early. Integrate anti-ligature hardware, tamper-resistant fixtures, glazing, ceilings, doors, plumbing and furniture with the clinical risk assessment. Late substitutions can undermine both safety and schedule.
- Plan therapeutic variety. Provide spaces for one-to-one therapy, groups, quiet withdrawal, movement, recreation, education, family meetings and culturally appropriate activities. A single multipurpose room rarely serves every need well.
- Protect staff workflows. Include secure charting and medication areas, team rooms, decompression or break spaces, lockers, training areas and routes that let staff reach patients quickly without unnecessary public exposure.
- Validate with users. Walk the plan with clinicians, peer-support workers, facilities staff, former patients and family representatives. Record conflicts and revise the operational brief before procurement.
What design features are reported to support a healing environment?
The projects in the source material use human-centered strategies, but the sources do not establish comparative clinical outcomes. Treat these features as design intentions and planning options that must be tested against safety, maintenance, climate and budget.
Nature, daylight and outdoor access
Views of trees or gardens, daylight, courtyards and protected outdoor areas can provide orientation and a change of sensory intensity. NBBJ’s completed Ohana Center in Monterey, California, includes dedicated gardens, including areas used for therapy and cooking, and private balconies. Outdoor access requires a clear risk assessment for falls, elopement, privacy, supervision, weather and ongoing horticultural maintenance.
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Choice, privacy and visibility
Patients may need to observe their surroundings while feeling protected. The Ohana project description mentions places that provide that balance, along with rounded edges and natural materials. In practice, use layered thresholds, alcoves, partial views, acoustic control and adjustable privacy rather than assuming that an entirely open plan is therapeutic.
Movement and sensory regulation
Movement areas, gyms, walking loops, quiet rooms and varied lighting can support different levels of stimulation. Specify durable, cleanable finishes and controls that staff can operate quickly. Avoid strong visual patterns, glare, unpredictable noise and difficult-to-repair details that can increase distress or operational burden.
Family and community connection
Family rooms, child-friendly waiting areas, education spaces and community partnerships can make treatment less isolating. Dr. Steven Packer of Montage Health described a “hub for comprehensive, innovative solutions, with concentric circles of care emanating throughout our community.” The 2021 article said the Ohana concept included an “Ohana House,” early intervention, youth and family support and community partnerships; treat those as the article’s original program description unless a current operator confirms each service.
What can the Big Lots Behavioral Health Pavilion teach project teams?
The Big Lots Behavioral Health Pavilion in Columbus, Ohio, opened in 2020. BD+C reported it as a nine-story, $159 million facility designed by NBBJ and built by Turner Construction. The reported program included 48 inpatient beds, 10 observation rooms for stays of up to 24 hours, a 12-bed stabilization unit for stays of up to 72 hours, a psychiatric crisis department and outpatient treatment.
The example demonstrates why “behavioral health” should be translated into a matrix of acuity and duration rather than a bed count alone. Emergency and observation functions have different arrival, security and staffing needs from inpatient units, while outpatient services need convenient access without exposing visitors to restricted areas. A vertical building can work, but elevators, compartmentation, evacuation, staff response and separation of public and secure circulation require early coordination.
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What is the current status and program of the Ohana Center?
The 2021 BD+C article described the Ohana Center as a $105.8 million Montage Health Foundation-funded project scheduled to open in early 2023. NBBJ’s project page, accessed November 13, 2026, now lists the 55,600-square-foot facility as completed.
According to NBBJ, Ohana includes a 16-bed residential program, outpatient services, partial hospitalization and intensive outpatient programming, as well as a café, gardens, a gym and a music room. The project page says the design was guided by neuroscience research and uses cross-laminated timber (CLT) and prefabrication. These are material and delivery choices, not proof that a particular structure or product improves treatment outcomes.
Dr. Susan Swick, MD, executive director of Ohana, is quoted on the project page: “The building itself becomes an element of our prevention program. It creates a sense of possibility, of hope, and the ways in which mental health must be built. Mental illness must be treated and its curable. But it must be built. The building itself is a reminder, a promise, and a facilitator.” Preserve the quotation’s wording, including “its curable,” when citing it.
Why does staff wellbeing belong in the facility brief?
Caregiver conditions affect retention, privacy and the reliability of daily operations, even though the supplied sources do not prove a causal link between a building and workforce outcomes. NBBJ’s Ohana project page states that behavioral-health staff turnover is approximately 40% and presents caregiver wellbeing as a design rationale. Attribute that figure to NBBJ; do not present it as an independently validated sector-wide statistic.
The page describes dedicated staff garden and break areas, private staff spaces and opportunities to recover from demanding encounters. A practical brief should also address acoustically protected team rooms, secure documentation, changing facilities, daylight, convenient restrooms, meal access, training and safe routes between departments. These spaces should be visible in the program and budget rather than treated as leftover rooms.
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How do CLT and prefabrication affect delivery?
Ohana’s use of CLT and prefabrication illustrates a project approach, not a universal prescription. CLT can influence structural spans, embodied-carbon calculations, fire and acoustic assemblies, moisture protection and procurement. Prefabricated components can improve repeatability and move some work into controlled conditions, but they require early design freezing, dimensional coordination, transport planning, inspection and a clear responsibility matrix.
For behavioral-health work, safety details must remain compatible with the chosen system. Confirm how doors, glazing, ceilings, wall protection, medical gases, plumbing fixtures, hardware and monitoring devices attach to prefabricated or mass-timber assemblies. Review acoustic privacy and reverberation, because group therapy and confidential conversations can be compromised by a structure that carries sound. Also verify local code, fire-resistance testing, insurance requirements, supply availability and maintenance access before committing to a system.
What should an AEC team measure during planning and handover?
Because the sources describe design strategies rather than clinical trials, teams should establish project-specific measures instead of promising outcomes. Useful measures include:
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- Time from arrival to clinical assessment and the number of handoffs between departments.
- Walking distance and response time for staff, patients, families, food, medications and emergency services.
- Percentage of patient rooms and treatment spaces with the intended level of observation and acoustic privacy.
- Availability and utilization of quiet, outdoor, movement, family and group spaces.
- Maintenance calls, repair times, ligature-risk findings and the durability of high-touch finishes.
- Staff break-space capacity, travel time to rest areas and post-occupancy feedback on noise, daylight, privacy and safety.
Post-occupancy review should distinguish building performance from clinical results. A comfortable garden may be well used, for example, without proving that it changes recovery rates. Report what was measured, over what period and by whom.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What are the most common planning mistakes?
- Using an acute-care template unchanged: Behavioral-health units need different observation, privacy, furniture and environmental strategies.
- Equating openness with healing: Excessive visibility can remove dignity and increase stimulation. Layer views and control access.
- Leaving safety to the end: Late anti-ligature or hardware changes can force costly redesign and create operational compromises.
- Under-sizing family and staff areas: Waiting, consultation, decompression and team functions are core parts of care, not optional amenities.
- Mixing incompatible acuities: Crisis, residential and outpatient users may require different entrances, circulation and supervision.
- Overclaiming neuroscience: A design described as neuroscience-informed still needs transparent assumptions, user validation and measurable post-occupancy review.
- Ignoring maintenance: Gardens, specialty finishes, prefabricated joints and complex hardware need realistic inspection and replacement plans.
How can AEC firms pursue this work responsibly?
Start by building behavioral-health competence inside the project team: involve clinicians, peer specialists, safety experts, facilities managers, code consultants and people with lived experience. Study the operator’s staffing and escalation protocols, not only its room list. Make the risk assessment, infection-control strategy, accessibility plan, acoustical criteria and maintenance model visible in design reviews.
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During procurement, require subcontractors to understand behavioral-health requirements and control substitutions through a documented review. During construction, protect the operational brief when schedule pressure appears. Before opening, train staff on doors, hardware, observation systems, garden access, emergency routes and maintenance procedures; a well-designed space can fail if users cannot operate it as intended.
The strongest opportunity described by the 2021 article is therefore not simply more square footage. It is better alignment between care, dignity, safety and construction delivery. Destigmatization may increase willingness to seek help, but each project still has to prove its value through a carefully defined program, responsible detailing and honest evaluation.
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Behavioral-health construction is a specialized, care-led building challenge. Historical reporting connected broader acceptance of treatment with opportunities for new facilities, while the Big Lots Pavilion and completed Ohana Center show how programs can combine crisis, inpatient, residential and outpatient services. For AEC firms, the durable lesson is to design for the actual population and acuity, balance privacy with observation, include families and staff, use nature and movement thoughtfully, and treat CLT or prefabrication as delivery tools rather than therapeutic guarantees.
Frequently Asked Questions
How much does a behavioral-health facility cost to build?
The supplied sources give one historical project figure—$159 million for the nine-story Big Lots Behavioral Health Pavilion reported in 2021—but no comparable cost-per-bed or current construction estimate. Budgeting requires a location-specific program, escalation date, security and anti-ligature scope, clinical equipment, site conditions, financing and operating model.
What codes apply to behavioral-health facilities?
Requirements vary by jurisdiction and facility type. The project team typically must coordinate building, fire, accessibility, healthcare, licensing, ligature-risk, emergency-power, infection-control and privacy requirements, then confirm the governing editions with the authority having jurisdiction and the healthcare operator.
Can a behavioral-health center share a campus with other healthcare services?
Yes, shared campuses can support referrals and community access, but circulation, entrances, elevators, waiting areas and emergency routes must be tested for acuity and privacy conflicts. Separate or controlled pathways may be needed for crisis patients, residential residents, outpatient visitors, deliveries and staff.
What should be included in a behavioral-health post-occupancy review?
Review safety incidents and near misses, room and garden utilization, acoustic and thermal complaints, staff response routes, maintenance failures, family feedback and access to quiet or movement spaces. Pair those observations with the date, operating conditions and any program changes so the findings are not mistaken for a clinical-outcome study.
